This book is composed by an author whose understanding of the topic is based upon vast surgical experience. A trustworthy evaluation of the success or failure of a micro vascular anastomosis or an aneurysm operation has actually previously been possible just postoperatively by angiography and transcutaneous Doppler sonography. Of specific impor tance are the stenoses and occlusions which can occur dur ing the operation, however which are regularly not identified un til after surgical treatment. This induced the neurosurgeons in Freiburg, in addition to those in a number of other healthcare facilities, to perform a rou branch control with postoperative transcutaneous Doppler fol lowing extracranial-intracranial bypass operations and an giography while still under anesthesia following aneurysm operations. The stenoses and occlusions spotted were typically not evident intraoperatively. The factors for this are that from the outside we see just the surface area – and not the lu men – of a v ~ ssel, and that stenoses triggered by apoplexy, indentation of the vessel wall during anastomosis or by plaque on the vessel wall are not externally obvious. Even arterial pulsation is no guarantee of patency. The requirement to be able to spot stenoses throughout the op eration is obvious. The microvascular Doppler sonography adopted by Dr. Gilsbach offers an expedient and safe technique of recognizing such lumen constrictings.
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